Dizziness: Is it your neck or your ears?

Dizziness-Is it vertigo or your neck causing your dizziness?


Have you ever suffered from dizziness? Has a doctor or a friend ever told you that you have vertigo? Did you know that vertigo is actually symptom and not a disease or pathology? Vertigo simply means you have dizziness.  If you have ever had any sort of dizziness then you technically have had vertigo.  There is a condition known as BPPV-benign paroxysmal positional vertigo that is often called vertigo.  BPPV is a mechanical problem in the inner ear. It occurs when some of the crystals (otoconia) that are normally embedded in gel in the utricle become dislodged and migrate into one or more of the 3 fluid-filled semicircular canals, where they are not supposed to be. When enough of these particles accumulate in one of the canals they interfere with the normal fluid movement that these canals use to sense head motion, causing the inner ear to send false signals to the brain.  Due to the term being loosely used in the medical world, people are often misinformed about what they have and what is causing it.  For example, tension in cervical spine can cause and mimic BPPV and result in nearly identical symptoms including dizziness, migraines and light sensitivity.   We refer to this as cervicogenic dizziness.  More often, I see a script from a doctor to treat vertigo (BPPV) and find after a few positional tests that inner ear canals are not the issue.  In fact I’m lucky if I get a true BPPV, however the awesomeness with BPPV is that it can usually be resolved in just a few sessions with a few positional maneuvers.    


So how can you find out what is causing your dizziness.    Here are a few signs to help you distinguish BPPV from something else.  First and foremost a hallmark sign of BPPV is that an episode of dizziness typically feels like the room is spinning.  Symptoms are provoked with different head movements, so if you turn in bed or look up to reach into a cabinet, it can often reproduce your dizziness.  In most cases your dizziness does not last more than minute.  So if your having bouts of dizziness that are last long period, it is probably something else causing it.   Another way to help distinguish BPPV would be to have someone watch your eyes when you are having an episode of dizziness.  The eyes typically “beat” in a certain manner that the person has no control of and they typically are unaware of it happening.  This is a way we as physical therapists are able to determine if it is BPPV or something else.  “The eyes don’t lie” is a saying we as therapists typically use when referring to BPPV due to the nystagmus(uncontrolled, repetitive eye movements) that occurs.


Another way to tell if your neck is causing your symptoms would be to sit on a stool that rotates and rotate the bottom half of your body while your head stays facing the same way like the picture below on the left.  If it reproduces your dizziness then it may be your neck that is causing your dizziness.  Another way to test things out would be to stand on a pillow or two and move your head at a steady pace from side to side and then up and down.  You want to be sure someone is around you to make sure you do not fall because if you have BPPV this will cause you to lose your balance.  Remember safety first.  If you are able to maintain your balance with minimal sway and do not become dizzy than it is likely not BPPV that is causing your symptoms  (see picture on the bottom).  

Those are usually my first go to tests to determine if I’m dealing with a cervical issue or vestibular issue.  From there depending on what makes you dizzy we are able to do additional testing to confirm the cause depending on the original findings.  


Whether your neck is causing your dizziness, crystals migrating in the inner ear canals, or something else, dizziness can be treated with physical therapy which most people are unaware of.  Why continue to suffer when this can be treated?  Get your new year started off on the right foot and give us a call and let us help you with your dizziness.  


If you find you are looking for more specifics as far a balance program tailored to your needs or someone you know, contact Chandler Physical Therapy at 480-786-4969 – you can request to speak directly to a physical therapist or have a FREE 1-on-1 chat with a physical therapist in a DISCOVERY SESSION!

Yours Truly,


Savannah Torrez, PT, DPT, COMT